经导管主动脉瓣置换术后冠状动脉阻塞的风险因素及预防研究进展

Research progress on risk factors and prevention of coronary artery obstruction after transcatheter aortic valve replacement

经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)已成为治疗主动脉瓣疾病的标准术式,目前适应证正逐步扩展应用于年轻及存在中低外科手术风险的患者。冠状动脉阻塞(coronary artery obstruction,CAO)是TAVR相关并发症之一,虽然发生率低,但死亡率很高。本文主要对TAVR相关CAO的危险因素识别、术前规避措施及术中处理进行综述,从而为临床降低其发生率及患者死亡率,进而改善主动脉瓣疾病患者预后提供参考。

Transcatheter aortic valve replacement(TAVR)is playing an major role in the treatment of aortic valve disease,and has been extended to young or low-risk patients.Although coronary artery obstruction(CAO)is a rare complication after TAVR,it carries a high risk of fatality.This paper reviews the risk factors,protective measures and management of CAO after TAVR,so as to provide reference for clinics to reduce its incidence and mortality,and further improve the prognosis of patients with aortic valve disease.